SARS-CoV-2 Among Migrants Recently Arrived in Europe From Low- and Middle-Income Countries: Containment Strategies and Special Features of Management in Reception Centers.

Silvia Fabris,Gabriele D'Ettorre,Giancarlo Ceccarelli,Massimo Ciccozzi,Ornella Spagnolello,Maurizio Lopalco,Paolo Vassalini,Gabriella D'Ettorre,Luigi Celani,Silvia Angeletti,Claudio M Mastroianni,Raissa Aronica,Alessandro Russo,Fausto D'Agostino,Simona Gabrielli

doi:10.3389/fpubh.2021.735601

Abstract

Despite the “migrants and COVID-19” topic has been neglected since felt marginal concerning other aspects of the SARS-CoV-2 pandemic, it represents a relevant public health issue in the European countries. This report describes COVID-19 containment strategies adopted in a large Italian reception center hosting recently arrived asylum-seeker migrants. Risk assessment and prevention measures adopted were described. Geo-spatial epidemiological analysis of the outbreak was reported. Significant gaps in the knowledge of self-protection measures from contagious diseases and in the perception of the pandemic risk were observed in migrants; health promotion activities, targeted to remove cultural barriers and improve behaviors appropriate to individual protection, were able to fulfill this gap. In low-resource settings, especially in closed communities, the implementation of social distancing strategies, the systematic use of individual protection devices, and active syndromic surveillance are essential tools to limit the risk of outbreaks. In the event of an outbreak, it is relevant to rapidly activate containment procedures based on systematic screening, isolation, and quarantine, taking into consideration the limits of tracing contacts within a closed community. Not being able to trace certain contacts, the geo-spatial epidemiological analysis of cases distribution could be key in the management of the outbreak. Interestingly, positive cases identified in our facility were all clinically pauci-symptomatic or asymptomatic. Dedicated strategies are needed to minimize the chance of SARS-CoV-2 transmission in a limited space such as reception centers and a vulnerable population such as migrants.

Highlights

Overall, 2.7 million immigrants entered the European Union (EU) from non-EU countries in 2019, mainly low- and middle-income countries
Following the SARS-CoV-2 outbreak in China and the first case of COVID-19 recorded in Italy, from March 9, 2020 to May 18, 2020, the Italian government imposed a national quarantine, severely restricting movements of the population except for necessity, public service work, and health circumstances, in response to the spread of the virus in the country
We investigated the association between testing positive for SARS-CoV-2 at T0 and living in Level 0 and in area C: among the 75 persons assigned to Level 0, 11 were positive for SARSCoV-2 at T0 (AR = 14.67%), showing a significant association between Level 0 and positivity (p = 0.007): the risk of being infected for who lived at Level 0 (RR) is 3.465 times higher than among who lived on others Levels

Summary

Introduction

2.7 million immigrants entered the European Union (EU) from non-EU countries in 2019, mainly low- and middle-income countries. Migrants living in refugee camps, detention centers, and reception centers are vulnerable to SARS-CoV-2 infection [4]. Individuals living in such overcrowded setting are less keen on following the basic prevention practices including social distance, hand hygiene, and self-isolation in case of exposure to SARSCoV-2. The management of coronavirus disease 2019 (COVID-19) risk for newly arrived migrants hosted in reception centers presents many challenges, mainly linked with the cultural and linguistic heterogeneity of this specific population. Heterogeneity in the perception of the risk related to COVID-19 and in the compliance with preventive measures to reduce the risk of transmission was reported among migrants coming from different countries [5, 6]

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Conclusion